Provider First Line Business Practice Location Address:
5600 14TH AVE NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98107-3723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-919-0175
Provider Business Practice Location Address Fax Number:
206-567-9797
Provider Enumeration Date:
09/21/2012